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Making stillbirths visible: a systematic review of globally reported causes of stillbirth

Reinebrant, HE; Leisher, SH; Coory, M; Henry, S; Wojcieszek, AM; Gardener, G; Lourie, R; ... Flenady, V; + view all (2018) Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG: An International Journal of Obstetrics and Gynaecology , 125 (2) pp. 212-224. 10.1111/1471-0528.14971. Green open access

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Abstract

BACKGROUND: Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD‐PM) aims to improve data on stillbirth to enable prevention. OBJECTIVES: To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD‐PM. SEARCH STRATEGY: We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016. SELECTION CRITERIA: Reports of stillbirth causes in unselective cohorts. DATA COLLECTION AND ANALYSIS: Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD‐PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC). MAIN RESULTS: Eighty‐five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD‐PM. All stillbirth causes mapped to ICD‐PM. In a subset from HIC, mapping obscured major causes. CONCLUSIONS: There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well‐resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings. FUNDING: HR, SH, SHL, and AW were supported by an NHMRC‐CRE grant (APP1116640). VF was funded by an NHMRC‐CDF (APP1123611).

Type: Article
Title: Making stillbirths visible: a systematic review of globally reported causes of stillbirth
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/1471-0528.14971
Publisher version: http://dx.doi.org/10.1111/1471-0528.14971
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Obstetrics & Gynecology, cause of death, classification, ICD, Stillbirth, systems, FETAL-GROWTH RESTRICTION, PERIOD ICD-PM, CLASSIFICATION SYSTEMS, PERINATAL-MORTALITY, NEONATAL DEATH, UNITED-KINGDOM, VERBAL AUTOPSY, SOUTH-AFRICA, CONSENSUS, RECODE
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10058020
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